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As the use of drugs and alcohol by clients accessing mental health services becomes increasingly common, members of staff working within psychiatric inpatient areas often encounter drug and alcohol misuse among their client group. The safe and effective management of this issue has become a priority for many inpatient services. This paper outlines a policy for the management of substance misuse on psychiatric inpatient wards developed by Manchester Mental Health and Social Care Trust. The fundamental principles underpinning the policy are highlighted, and the key sections of the policy are described. There is a detailed description of how the policy has been applied in practice by members of staff working on inpatient wards, with clinical examples being presented.

In this article we explore how inpatient mental health services in England and Wales are interpreting and responding to policy derived from Mainstreaming Gender and Women's Mental Health (DH, 2003) in relation to women's safety in inpatient settings. This article will outline the background to concerns about safety in mental health settings for women and drawing on relevant literature and on interviews with service managers, practitioners and users identify some current issues in improving safety for women in inpatient settings and in creating single sex provision. Our review suggests that whilst there are improvements in provision for women in inpatient settings, some women are still not being offered a real choice of a women‐only setting on admission to hospital, and that changing the culture that permits a lack of physical and relational safety for women presents real challenges. We will discuss some of the implications for future practice.

Behavioural activation is a contemporary behavioural treatment for depression that has the potential advantages of being more readily adopted in psychiatric inpatient environments than more complex psychological treatment approaches and requiring less intensive training than these approaches. In this article the theoretical and empirical foundations of behavioural activation are described along with an outline of the therapeutic process and key interventions used. Consideration is then given to factors influencing the implementation of BA in psychiatric inpatient environments.

Although long a feature of inpatient mental health ward routine, community meetings have not always attracted a clear sense of purpose and value. A common complaint from patients is that community meetings are useless and have no worthwhile purpose. It was thought that staff on acute wards would benefit from having a space to think about community meetings, and a work discussion group was provided over a duration of 18 months. It was hoped that this intervention would enable facilitators to think about these meetings and about their aims and benefits. This paper presents findings from the work discussion group: staff facilitators' experience of facilitating community meetings and patients' direct feedback to facilitators about their experience of these meetings. The conclusions made are that community meetings could provide a useful forum for patients and staff if they:• are of benefit to patients• provide a forum for development of the therapeutic alliance between patients and staff• contribute towards improvement of the ward milieu• provide a forum for staff to develop therapeutic skills• provide a forum for staff to develop working relationships with colleagues and different professionals in the team.

This paper looks at the evolving nature of mental health services. While there has been a shift from asylums to care in the community in recent decades, what is now needed is another shift of acute inpatient psychiatric care, away from psychiatric units to community hospitals and other community settings. It is argued that this would be a further step forward in the evolution of mental health services as it would benefit the service users, their families, carers and staff working in acute psychiatric inpatient units.

Patients who have intellectual disability and mental illness will occasionally need inpatient treatment. However, research is sparse on psychosocial factors influencing psychiatric units for patients with intellectual disabilities. The aim of this study is to examine whether adults with intellectual disabilities can reliably rate the Ward Atmosphere Scale – Real Ward (WAS‐R).

A total of 17 patients with mild and moderate intellectual disability and 21 staff members were asked to complete the WAS‐R. The authors used six subscales (involvement, support, practical orientation, order and organisation, angry and aggressive behaviour, and staff control) that have proved to be of major importance for patient satisfaction and treatment outcome to measure the patients' and the staff members' perceptions of the treatment milieu. To examine the internal consistency Cronbach's alpha was calculated for the patient and staff scores, respectively.

A total of 16 patients completed the form. Patients with mild intellectual disabilities were able to answer the WAS with some help, whereas patients with moderate intellectual disabilities had major difficulties with understanding more than half of the WAS items. These difficulties were also reflected in the internal consistency scores. Cronbach's alpha was satisfactory (≥0.50) for five subscales for patients with mild intellectual disabilities, but only satisfactory for two of the six subscales for patients with moderate intellectual disabilities.

A replication study should use a shorter version of the WAS‐R, and family or caregivers should answer the WAS‐R additionally to the patients.

This study may encourage more research on treatment milieu for patients with intellectual disability and mental illness.

National mental health policies in the UK have a common theme of seeking to develop working partnerships between people who use mental health services, their families and carers and professionals. In Somerset, following a staff training programme, a Family Liaison Service has been developed whereby systemically trained staff work alongside inpatient staff to hold family meetings as part of the assessment and admission process on all wards for working age adults and older people. This article aims to focus on this initiative.

The article considers the development of the Family Liaison Service and evaluates its progress based on audit data, feedback from families using the service, and a survey of staff experience. Issues raised in developing family inclusive services are discussed.

Evaluation of the service suggests that, although there is still progress to be made, considerable success has been achieved in embedding the service on inpatient units with a substantial increase in meetings held between staff and families. Feedback from families is positive and staff report increased confidence in engaging with families and carers.

This article describes a transferable model for the implementation of national policy to develop working partnerships with families and carers in mainstream mental health services.

A high and possibly increasing prevalence of mental disorders in prisoners has been demonstrated in recent surveys. Psychiatric care of prisoners is subject to wide regional variations in Germany, especially regarding inpatient treatment. Although hospitalized psychiatric patients in prison closely resemble those in forensic psychiatric secure hospitals with regard to socio‐demographic (percentage of women, age peak) and forensic characteristics (delinquency, prison experience), marked discrepancies in the diagnostic spectrum necessitate very different treatment planning based on general clinical psychiatry when considering the approach and especially the treatment duration. In Berlin, we try to develop a care structure within the prison system, which addresses inmate‐specific problems and circumstances as well as the possibility of inpatient and outpatient treatment and semihospitalization according to the principle of “equivalence”.

This position paper focuses on the current tensions and challenges of aligning inpatient care with innovations in mental health services. It argues that a cultural shift is required within inpatient services. Obstacles to change including traditional perceptions of the role and responsibilities of the psychiatrist are discussed. The paper urges all staff working in acute care to reflect on the service that they provide, and to consider how the adoption of new ways of working might revolutionise the organisational culture. This cultural shift offers inpatient staff the opportunity to fully utilise their expertise. New ways of working may be perceived as a threat to existing roles and responsibilities or as an exciting opportunity for professional development with increased job satisfaction. Above all, the move to new ways of working, which is gathering pace throughout the UK, could offer service users1 a quality of care that meets their needs and expectations.

The purpose of this mixed methods rapid study was to identify the barriers and facilitators to implement relational and environmental risk management approaches to manage suicidality in inpatient services.

To achieve this within a short timeframe, a rapid review approach was chosen. Both research (qualitative and quantitative studies) and non-research material (policies, guidance and reports) were retrieved. The review was conducted across five databases: MEDLINE, EMBASE, EMCARE, PsycINFO and CINAHL for English language citations within the last ten years (2009 –2019).

A total of 17 primary research papers and a further 73 reviews and grey literature were included. There was evidence that the removal of anti-ligature equipment, by which regular checks of the environment to identify and remove ligature points and increased levels of observation are carried out well, reduces suicide in hospital.

There is a gap in research investigating “engagement activities” eliciting exactly what they are and determining how they might be effective. There is a need for new innovative ways for managing risk of suicide in hospitals that bring together meaningful engagement and maintaining safety.

Keeping people safe during an inpatient stay in a mental health service is a core function of mental health practitioners. This paper brings together what is already known about risk management and highlights areas for further investigation.